Current options for internal fixation of skeletal fractures and osteotomies include metallic devices consisting of stainless steel and titanium. These materials obscure the image of the fracture and osteotomy after their application due to their inherent property of radiopacity on X-ray evaluation. Carbon fiber in plating systems has been developed in the past, but have not exhibited the stability and durability of their metallic counterparts.
One of the most common post-operative issues from fracture and osteotomy reduction is non-union of two boney fragment ends following surgical reduction. Non-unions occur for a number of different reasons including instability at the fracture or osteotomy site and soft tissue impingement between the fragments. While these causes of non-unions can be abated by proper surgical technique, other pathologic process exist, which effect bone healing that are not as directly treated and involve a multifaceted approach. These conditions include metabolic disorders, immune-compromised, elderly, malnourished, neuropathic, morbid obesity, smokers, alcoholics, and noncompliant patients. Adjunctive treatments for boney nonunion can involve diet and medication supplementations, external capacitative coupling bone stimulators or even surgical procedures to increase the rigidity of the boney fixation construct or implantation of a direct current bone stimulator device (Osteogen, Biomet). These enhancements in the care of non-unions have all been shown by peer reviewed research to increase the rate of boney healing following the diagnosis of bone non-union.